From time to time on the Neurosurgery Blog, you will see us cross-posting or linking to items from other places when we believe they hit the mark on an issue. We wanted to bring attention to a recent publication in Neurosurgery, the official journal of the Congress of Neurological Surgeons, which provides multimedia, prompt publication of scientific articles on clinical or experimental surgery topics important for the brain, spine, and peripheral nerves, reviews, and other information of interest to readers across the world. The article, “High-Accuracy Augmented Reality Guidance for Intracranial Drain Placement Using a Standalone Head-Worn Navigation System: First-in-Human Results” is published as part of Neurosurgery’s High-Impact Manuscript Service (HIMS).
Published online ahead of print on March 20, the article indicates that placing an external ventricular drain (EVD) at bedside using high-accuracy augmented reality (AR) guidance based on a standalone head-worn navigation system is more precise than freehand placement, resulting in a more than twofold increase in optimal placements, and fewer reinterventions and complications.
According to the Wolters Kluwer press release, “AR guidance resulted in better placement outcomes with functional placement in all cases versus seven in the freehand group (statistically significant difference), successful in nine versus five, optimal in eight (including two slit ventricle cases) versus three (statistically significant difference), and failed in zero versus one. No AR-guided placement required revision, but four freehand placements did, another statistically significant difference. ‘The reinterventions, along with the implied multitude of attempts, constituted the primary cause of all procedure-related complications in the freehand group, . . . once more emphasizing the hazard related to multiple stick-and-poke attempts and the importance of first-attempt success.’”
“Although for some cases freehand placement might have been equally successful, the distinct improvement over the control group indicates that the freehand technique may not consistently yield straightforward results. The performance in slit ventricle cases further substantiates these presumptions because accomplishing successful ventricular puncture can be notably challenging, especially within a single attempt,” reports Frederick Van Gestel, MD, and his colleagues. Building on their initial success, the researchers are planning a multicenter randomized controlled trial, which is scheduled for launch at the end of 2025.
To read the full Neurosurgery article, click here.
Image from Figure 2, Van Gestel F, Frantz T, Buyck F, et al. High-Accuracy Augmented Reality Guidance for Intracranial Drain Placement Using a Standalone Head-Worn Navigation System: First-in-Human Results. Neurosrugery. 2025. DOI: 10.1227/neu.0000000000003401
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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